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Impotence or Erectile Dysfunction

Having diabetes, being overweight or having blocked arteries or high blood pressure can make a man impotent. More than 80 percent of impotence is caused by arteriosclerosis blocking arteries or by diabetes because you need open arteries and undamaged nerves to have an erection (1). A study from the University of Pittsburgh School of Public Health shows that as men age, their blood levels of the male hormone, testosterone, drop. and those whose testosterone levels drop the most are the ones with high blood pressure and high blood cholesterol and sugar levels (2). Arteriosclerosis blocks arteries and damages testicles and interferes with their ability to make the male hormone, testosterone.

If you are impotent, check with your doctor who will check for diabetes, cholesterol, testosterone and a brain tumor that makes too much prolactin. He should order the following blood tests: CBC, chemistry. HDL/LDL cholesterol, HBA1C, Prolactin, testosterone, Vitamin B12/folic acid. He should also check to see if you are taking any medications that cause impotence. If your blood sugar or cholesterol is high, you need to start a high-plant diet based on fruits, vegetables, whole grains and beans, start a controlled exercise program, lower high blood pressure and reduce to a normal weight if you are overweight. Chances are that your testosterone will also be low.

A man has two balloons in his penis that fill with blood when he has an erection. The penis is different from all other tissues in the body. It has small muscles that close the arteries most of the time. If the muscles didn't squeeze the blood vessels bringing blood to the penis, a man would have an erection all the time. A man develops an erection when the muscles surrounding the blood vessels relax to increase blood flow into the balloons. The balloons then fill and press on and close the veins that carry blood from the penis. The treatment for impotence is to relax the muscles so more blood can flow into the penis. First there were alprostadil injections called Caverjet, then there were alprostadil pellets called Muse that could be inserted into the urinary tube. Apomorphine stimulates the brain to cause an erection and phentolamine blocks adrenaline to relax the muscles and cause an erection. Viagra (sildenafil) and similar drugs are taken one hour before making love. They can cause headaches and diarrhea. Spontane (apomorphine) is not as effective and still requires a potent mental stimulant and touching to cause an erection. Vasomax (phentolamine) is not as effective and requires intense stimulation for an erection.

However, none of these drugs do anything to alter the cause of the impotence. Eighty-five percent of impotence is caused by arteriosclerosis or diabetes, and may be reversible if those conditions are treated properly. See my heart health reports and treatment of diabetes

1) JM Zmuda, JA Cauley, A Kriska, NW Glynn, JP Gutai, LH Kuller. Longitudinal relation between endogenous testosterone and cardiovascular disease risk factors in middle-aged men - A 13-year follow-up of former Multiple Risk Factor Intervention Trial participants. American Journal of Epidemiology 146: 8 (OCT 15 1997):609-617.

2) JM Zmuda, JA Cauley, A Kriska, NW Glynn, JP Gutai, LH Kuller. Longitudinal relation between endogenous testosterone and cardiovascular disease risk factors in middle-aged men - A 13-year follow-up of former Multiple Risk Factor Intervention Trial participants. American Journal of Epidemiology 146: 8 (OCT 15 1997):609-617.

3) OEF Elrufaie, A Bener, MSO Abuzeid, TA Ali. Sexual dysfunction among type II diabetic men: A controlled study. Journal of Psychosomatic Research 43: 6 (DEC 1997):605-612.

4) yohimine is ineffective. C Teloken, EL Rhoden, P Sogari, M Dambros, CAV Souto. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. Journal of Urology 159: 1 (JAN 1998):7320. Dirty pictures enhance effects of injecitons. F Montorsi, G Guazzoni, L Barbieri, L Ferinistrambi, S Iannaccone, G Calori, L Nava, P Rigatti, G Pizzini, A Miani. Genital plus audiovisual sexual stimulation following intracavernous vasoactive injection versus re-dosing for erectile dysfunction - Results of a prospective study. Journal of Urology 159: 1 (JAN 1998):113-115.

Checked 12/2/13

August 20th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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